The State Board of Healing Arts, the licensing board for doctors, has proposed that physician assistants in rural areas be supervised by doctors for 100% of clinic hours if lawmakers don't act.

There are two opposing bills pending in the legislature right now that could address how long physician assistants need to be supervised.

Rep. Robert Schaaf (R-St. Joseph) has a bill that says supervising physicians in rural clinics must be present a minimum of 80% of the clinic hours. The Missouri Association of Osteopathic Physicians and Surgeons is the group strongly lobbying for this bill. They want strict rules restricting physician assistants from treating patients without supervision.

Rep. David Sater (R-Cassville) has a bill that says supervising physicians in those clinics must be present just 10% of the time. The Missouri Academy of Physician Assistants is pushing hard for this bill. They believe PAs are being unfairly targeted, and say thousands will lose access to quality health care if the rule is passed.

Rep. Schaaf tells the KY3 Political Notebook that physician assistants who currently see patients without a doctor present are already breaking the law. Schaaf said the current statute already requires supervision. "They are erroneously ignoring the law. They have not been enforcing it," Schaaf said.

But Connie Farrow, a spokeswoman for the Missouri PAs, says the Board of Healing has installed an exception to the 100% rule for rural clinics that will expire this summer -- if lawmakers fail to change it.

"Physician assistants were never intended to be autonomous. And they do not have the training of a physician. We have to stand up for principle as well as expedience. It may be expedient for them to do this, but it is not principled," Schaaf said.

The President of the Missouri Academy of Physician Assistants says health clinics will be forced to close in rural areas of our state where there is a physician shortage. "Patients will be forced to travel greater distances for medical treatment," Winter said, endorsing Rep. Sater's HB 497.

If lawmakers fail to act on both bills, the Board of Healing's 100% supervision rule will go into effect this August. The rural medical clinic in Hartville, Mo. said that strict rule would most likely force them to close their doors.